Archived: Caxton Lodge

Updated 29 January 2015

The inspection team consisted of a lead adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using, or caring for someone who uses, this type of care service. This expert by experience had personal experience of caring for someone who used a care service for people living with dementia.

Prior to our visit, we reviewed all the information we held about the service. This included events we had been notified about and any comments or complaints we had received. We also reviewed information sent from the provider about various aspects of the service, such as staffing levels and training figures.

The registered manager of the home had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Before our inspection we reviewed the information provided within the PIR.

During the inspection we spoke with four people who used the service and four relatives. We also spoke with four staff members including the registered manager and care workers. Two community professionals involved with the service, a social worker and a dementia care specialist, shared their views of the service with us.

We closely examined the care records of three people who used the service. This process is called pathway tracking and enables us to judge how well the service understand and plan to meet people’s care needs and manage any risks to people’s health and wellbeing.

Throughout our visit we carried out observations, including how staff responded to people and supported them and daily activities such as the lunch time service. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a variety of records including some policies and procedures, safety and quality audits, staff personnel and training files, records of accidents, complaints records and various service certificates.

This report was written during the testing phase of our new approach to regulating adult social care services. After this testing phase, inspection of consent to care and treatment, restraint, and practice under the Mental Capacity Act 2005 (MCA) was moved from the key question ‘Is the service safe?’ to ‘Is the service effective?’

The ratings for this location were awarded in October 2014. They can be directly compared with any other service we have rated since then, including in relation to consent, restraint, and the MCA under the ‘Effective’ section. Our written findings in relation to these topics, however, can be read in the ‘Is the service safe’ sections of this report.

Updated 29 January 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2012 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by the Care Quality Commission (CQC), which looks at the overall quality of the service.

The inspection was unannounced.

Caxton Lodge is a small care home in a residential area of Blackpool, between Bispham and Norcross. The home provides personal care for people who live with varying degrees of dementia and can accommodate a maximum of nine people. At the time of our inspection there were nine people using the service. The home has two lounges and a dining room. All bedrooms have hand wash basins. There are six single bedrooms on the first floor and three bedrooms on the ground floor. There is a passenger lift between the two floors.

There was a registered manager in place at the home. A registered manager is a person who has registered with CQC to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Infection control procedures were in place but not always followed. Standards of cleanliness and hygiene were variable. The infection control procedures did not reflect current legislation and best practice guidance. This meant that people who used the service were not fully protected against the risks of cross infection.

The arrangements for monitoring quality and assessing risks were inconsistent and sometimes ineffective. We identified some issues, for example, environmental risks, that had not been assessed, and as such, there was no plan in place to manage them. This meant that the health and safety of people who used the service could be compromised.

We found several breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

Throughout the inspection we consulted a number of people who used the service, their relatives and some community professionals. We received good feedback from people and all those we spoke with expressed general satisfaction with the service provided at Caxton Lodge.

People we spoke with including people who used the service, their relatives and community professionals, were able to tell us about positive outcomes experienced by people who used the service due to the support they received.

People felt that staff understood their needs and provided care in line with their personal preferences. Care workers were aware of people’s individual care plans and the support they required.

There were processes in place to ensure that people who used the service were protected from abuse. Staff received training in this area and demonstrated good understanding of safeguarding procedures.

The rights of people who did not have capacity to make certain decisions about their care were protected. Where decisions were made in a person’s best interests, the registered manager ensured the person’s representatives and other professionals involved in their care were involved.

Staffing levels were calculated in line with the needs of people who used the service. People felt that there were enough staff on duty at any one time, to meet their or their loved one’s needs and that staff were competent to carry out their roles.

People who used the service, their relatives and staff felt able to raise concerns. People felt confident that any concerns they did raise would be dealt with properly.